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General NPI Number Information
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NPI Number | 1417391319
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Entity Type | Organization
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Legal Business Name | MARIUS KILLIAN NIKOLAS DITURSI MD PC
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Dates
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Enumeration Date | 04/22/2013
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Last Update Date | 07/24/2023
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Provider Practice Location Address
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Address Line | 127 CANVASS ST
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City | COHOES
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State | NY
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Zip | 12047-3030
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Country | US
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Telephone | 518-233-9500
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Fax | 518-660-0770
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Provider Business Mailing Address
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Address Line | 127 CANVASS ST
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City | COHOES
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State | NY
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Zip | 12047-3030
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Country | US
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Telephone | 518-233-9500
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Fax | 518-660-0770
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Authorized Official
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Title or Position | OWNER, PRESIDENT
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Name | DR. MARIUS KILLIAN NIKOLAS DITURSI
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Credential | MD
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Telephone | 518-233-9500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 263723
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License Number State | NY
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